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Coping With Side Effects of Antidepressants

Like any medication, antidepressants can cause side effects. The specific problems vary from drug to drug -- and from person to person.

In fact, side effects are one of the main reasons that people with depression stop taking their medicine during their recovery. A 2003 study published in Current Medical Research and Opinion found that 65% of the 1,000 people surveyed said they had stopped taking their medicine, and half of those people cited side effects as the reason.

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Yet it's important to keep in mind that antidepressants can help you recover. The American Psychiatric Association recommends that people keep taking their medicine at least for four to five months after they recover from a first depressive episode in order to reduce the risk of relapse. And for people who have had multiple previous episodes, the recommendation is often longer (or even to continue indefinitely).

Newer antidepressants such as Prozac, Paxil, Zoloft, Effexor, Cymbalta, Viibryd, and Wellbutrin generally have fewer and less severe side effects than older drugs. The side effects vary depending on the drug but can include:

Insomnia
Sleepiness
Increased anxiety
Nausea or vomiting
Diarrhea
Sexual problems, such as delayed ejaculations in men and lack of orgasm in women
Headaches
Dizziness
Weight gain or loss

Other more serious side effects are rare but possible. Antidepressants have been linked to an increase in suicidal thinking and behavior in children and adolescents. Talk to your doctor about what symptoms to watch for during your depression recovery.

Some of the older tricyclic antidepressants such as Elavil, Pamelor, and Tofranil can have severe side effects or cause dangerous interactions with other drugs or foods. They can cause blurred vision and fatigue. They may not be safe for people with heart problems. High doses can be toxic and potentially life-threatening. For these reasons, tricyclic antidepressants are less often used for the treatment of depression.

Monoamine oxidase inhibitors (MAOIs) such as Nardil, Parnate, Marplan and Emsam are among the most effective of all known antidepressants. But they can cause serious interactions with some foods -- like certain cheeses, red wine, and certain beans -- and other medicines. The interactions can result in potentially fatal high blood pressure. For instance, they can be hazardous when combined with medicines such as Sudafed (pseudoephedrine) that can raise blood pressure. They can also be dangerous with most other antidepressants that can then excessively raise levels of the neurotransmitter serotonin.

What to Do About Antidepressant Side Effects

With any medication, you have to weigh the benefits with the side effects. You and your doctor should work together to figure out the right balance. Some side effects may not bother you. Others may be so severe that you will have to stop taking the medicine.

Keep in mind that side effects might be worse when you first start a medicine or when you increase the dose. They may get better as your body adjusts. So if your side effects are mild, your doctor may want you to stick with your depression medicine to see if the side effects go away on their own.

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